( )A copy of the proof from the Department of Public Safety and
Corrections, office of motor vehicles, that it has received from the
clerk of court a certified copy of the record of the plea, fingerprints of
the defendant, and proof of the requirements set forth in C.Cr.P. Art.
556, which shall include the defendant's date of birth, last four digits
of social security number, and driver's license number

5. Mover has attached to this Motion the following pertinent documents:

□Criminal Background Check from the La. State Police/Parish Sheriff
dated within the past 30 days (required).

□Bill(s) of Information (if any).

□Minute entry showing final disposition of case (if any).

□Certification Letter from the District Attorney for fee waiver (if
eligible).

□Certification Letter from the District Attorney verifying that the
applicant has no convictions or pending applicable criminal charges
in the requisite time periods.

□Certification Letter from the District Attorney verifying that the
charges were refused.

□Certification Letter from the District Attorney verifying that the
applicant did not participate in a pretrial diversion program.

□A copy of the order waiving the sex offender registration and
notification requirements.

□Documentation verifying that the mover has been employed for ten
consecutive years.

□A copy of the court order determination of factual innocence and
order of compensation for a wrongful conviction pursuant to the
provisions of R.S. 15:572.8 if applicable.

The Mover prays that if there is no objection timely filed by the arresting law
enforcement agency, the district attorney's office, or the Louisiana Bureau of Criminal
Investigation and Information, that an order be issued herein ordering the expungement of
the record of arrest and/or conviction set forth above, including all photographs, fingerprints,
disposition, or any other such information, which record shall be confidential and no longer
considered a public record, nor be made available to other persons, except a prosecutor,
member of a law enforcement agency, or a judge who may request such information in
writing, certifying that such request is for the purpose of prosecuting, investigating, or
enforcing the criminal law, for the purpose of any other statutorily defined law enforcement
or administrative duties, or for the purpose of the requirements of sex offender registration
and notification pursuant to the provisions of R.S. 15:541 et seq. or as an order of this Court
to any other person for good cause shown, or as otherwise authorized by law.

If an "Affidavit of No Opposition" by each agency named herein is attached hereto
and made a part hereof, Defendant requests that no contradictory hearing be required and the
Motion be granted ex parte.